Heart disease is the leading cause of death in the United States for both men and women. Despite this reality, women with heart disease appear to have a substantial disadvantage to men. There is considerable debate as to exactly why heart disease treats the sexes differently; however, most experts agree that a woman who can recognize her level of risk and knows the warning signs of a heart problem is in a better position to survive an unfortunate cardiac event.
There is a substantial need for increasing our education on women’s cardiovascular disease. According to a 2006 American Heart Association survey, the following deficiencies were discovered:
- Fourty-three percent of women were unaware that heart disease is the leading cause of death among women.
- Among primary care physicians, only 8 percent knew that more women than men die each year from cardiovascular disease.
- Many women do not recognize the warning signs or symptoms of a heart attack, which can be more subtle than those exhibited by men.
- This lack of awareness typically results in less aggressive and sophisticated diagnosis and treatment – which undoubtedly results in poorer outcomes.
Heart Attack Symptoms
Signs of a heart problem are typically more pronounced in men, and thus they tend to get help sooner than women. Often the first inclination that someone has cardiovascular disease, heart attacks can be a fatal event. While many of us associate the classic symptoms of crushing chest pain, sweating and shortness of breath with a heart attack, women often have a different representation:
- Although chest pain may exist, women are less likely than men to report chest pain during a heart attack.
- Women are more likely than men to have unconventional heart attack symptoms like fatigue, malaise, shortness of breath, nausea, depression, upset stomach, pain in the jaw, back or shoulders.
Heart Disease Risks
While men and women share a lot of the same risk factors for cardiovascular disease, there are some important differences:
- Smoking – Smoking cigarettes represents the single largest risk for heart disease for both sexes. However, women who take birth control pills and smoke have a much greater risk of heart attack and stroke.
- Cholesterol – LDL cholesterol (the bad cholesterol) levels above 130 mg/dL are a greater risk for men while HDL cholesterol (the good cholesterol) levels below 50 mg/dL are a greater risk for women. In addition, high triglyceride levels (over 150 mg/dL) are a more significant risk factor for women than men.
- Abdominal Girth – Abdominal fat releases substances that interfere with insulin activity and promote the production of bad cholesterol. Some experts believe that a waist measurement of 35 inches or more for women and 40 inches or more for men carries significant heart disease risk.
- Inflammatory Disorder – Many healthcare providers recognize the growing problem of chronic inflammatory disorders in women. Likely because chronic inflammation aids in the deposition and buildup of plaque in the arteries, disorders that involve persistent, low-grade inflammation (like lupus) puts women at greater heart disease risk.
Possible Explanation
Different opinions exist as to why there are different heart disease risks and heart attack symptoms between men and women. However, a relatively new explanation is that women may suffer from a different form of heart disease than most men. According to research led by the National Institutes of Health, women tend to accumulate plaque evenly inside their major arteries and small blood vessels. On the other hand, men tend to develop obvious blockages in their coronary arteries – the arteries that supply blood to the heart.
“We’re realizing that this may be fairly common among women,” said George Sopko of the National Heart, Lung and Blood Institute, which is funding the research. “This is a big deal. This is changing our thinking about heart disease in many women.”
Until we have better resources to detect, prevent and treat cardiovascular disease, women must be aware of their heart’s health. As more women educate themselves on their heart disease risk and potential heart attack symptoms, they will be less likely to delay getting help when it is needed – a shift that will increase a woman’s chances of surviving a heart attack.
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